The call was simple enough. Travel to a remote area of Canada to provide medicine to needy people. I was expecting a rough town with a jagged past. What I found was heartbreaking. A town that seemed forgotten. Forgotten in spite of the gruesome school shooting by a minor that took 4 lives and wounded 7 others.
So where do I even begin? I was optimistic initially. I arrived after dark and found my place nice enough. I woke to the sun the next morning delighted to find that the town is situated on the East side of a beautiful lake. The hospital has the most wonderful view right along the shore with dazzling sunsets.
Reality set in quickly in clinic when I saw a paper chart waiting for me at the door of my first patients room. It was not the first I have ever seen. In training once I had to fetch an old chart to look up information that had not made it into his electronic record years ago. A call back to former times. My first thought was “how do I even use this thing?”. It didn’t get easier from there. I struggled to find old notes, old x-rays, old prescriptions, past medical conditions. I couldn’t help but be surprised that I found myself wishing there were some sort of manual to use a ‘technology’ so simple. Then it struck me, is this the type of care a scarred and hurting town gets? Has everyone forgotten about La Loche?
I struggled my first days there. Trying to come to grips with the lack of proper medical resources and care for a town in need. Trying to understand how a town of roughly 3000 people could have 2 grocery stores, 2 take out restaurants, a bar, a gas station and a liquor store. The other businesses in the town are government buildings. At about the same size Port Hardy had a hotel, restaurants, cafe’s, hardware stores. It seemed a town of potential that had never been realized. Like a beautiful swingset on a beach without any swings…
La Loche is a town with a marred past. Not just the school shooting either. It boasts one of the highest crime rates in Canada, including violent crimes like homicides. The nurse and physician residences have been broken into and sometimes gutted on several occasions, mostly when vacant. There was quite obvious damage to the deadbolt of my apartment. Dogs roam the streets unhindered and wild, free to give chase to joggers that may happen by. The hospital was ill equipped for its residents’ needs. There was no patient room to properly protect others from contagious TB patients. Resources for those with an acute mental health crisis were lacking. The emergency room had no proper place to house them, and when they needed specialist help in a secure facility it was a monstrous task to transport them out. Health care workers faced burnout due to chronic understaffing. One day we had to discuss transferring the patients that were currently admitted because we only had one registered nurse in the entire hospital (we usually had 3). Public health initiatives are badly needed here, as many parents bottle feed their children up to 3 years of age. Due to poor nutrition almost every child I see had a mouth full of cavities and too many are anemic.
La Loche was an enigma. I could not fully understand or accept how it came to be, and why nothing was happening about it. I asked fellow physicians what they were able to understand about it, but found out they were also puzzled and disappointed. Reaching out to town residents, they most often shrugged. They were almost complacent, resigned. As if the question was one they had not thought of for a long time. Some were, rightfully, a little taken back and defensive. When they saw my heart was genuine, they often offered that it was complicated. The suicide rate is up to 40x the national average. Few people here haven’t been affected by it. The legacy of residential schools is still fresh as well. Local schools only closed their doors in 1976 and 1983. Adults no doubt still live with the hurt these institutions.
Around half the adult population is on some sort of social assistance. Those that decide to work are often chastised for being too good for welfare. This town, this land is their community, their lives. They visit one another in their homes. Family ties run deep in La Loche, the majority of people have one of 5 common last names. Their streets are even named after these families. Some go out on the land hunting and go fishing on their beautiful lake summer and winter. It is hard for people to leave their land and family, but then their is little industry to keep them employed. Drugs and alcohol rule the town relatively unchecked.
A town forgotten. The massive mobilization of public health and community resources was strangely absent. I think that is the most frustrating part!
“Why do people have to drink so much?”, I lamented to a gentlemen I was stitching up. He had been hit in the head with a wine bottle after passing out. His reply?
“People here are hurt”.
So where is the massive public push for more health resources for addiction treatment, public health initiatives and mental health supports. I can only answer that this town is politically weak and isolated, and easy to forget. Just another blip on the map of historically terrible First Nations and Metis relations.
I have not forgotten.